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Transcaval access for TAVR across a polyester aortic graft
Author(s) -
Lederman Robert J.,
O'Neill William W.,
Greenbaum Adam B.
Publication year - 2015
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25781
Subject(s) - medicine , surgery , aorta , aortic valve , cardiology
Transcaval access to the aorta allows transcatheter aortic valve replacement in patients without other good access options. The resulting aorto‐caval fistula is closed with a nitinol cardiac occluder device. There is no experience traversing a synthetic aortic graft to perform transcaval access and closure. We describe a patient who underwent successful traversal of a polyester aortic graft using radiofrequency energy applied from the tip of a guidewire, to allow retrograde transcatheter aortic valve replacement from a femoral vein, along with details of our technique. The patient did well and was discharged home after 3 days. There was residual aorto‐caval fistulous flow immediately after implantation of a polyester‐seeded nitinol muscular ventricular septal defect occluder device, but this fistula spontaneously occluded within one month. © 2015 Wiley Periodicals, Inc.